Quality of life in 1931 adult patients with epilepsy: Seizures do not tell the whole story

ObjectiveThe aim of the work described here was to characterize quality of life (QOL) and its determinants in a large cohort of adult patients with epilepsy.MethodsValidated measures reflecting disease severity and psychosocial functioning were electronically collected on all outpatients seen during 2009. Multivariate regression adjusting for repeated measures identified determinants of QOL, as defined by the Quality of Life in Epilepsy Questionnaire-10 (QOLIE-10).ResultsSeven thousand seven hundred eighty-four visits from patients with epilepsy were identified. The questionnaire completion rate was 77%, yielding 5960 records corresponding to 1931 individual patients for analysis. Following multivariate modeling, the two most clinically significant QOL predictors were seizure severity (mean QOLIE-10 score = 28.8 if LSSS > 40 vs 19.2 otherwise) and depression (mean QOLIE-10 score = 31.7 if PHQ-9 ≥ 10 vs 19.3 otherwise).ConclusionsOptimizing quality of life in patients with epilepsy requires an approach that extends beyond controlling seizures. Collection of validated health status measures improving patient management is possible within the setting of routine clinical care.

► Determinants of quality of life in approximately 2000 adult patients with epilepsy were examined. ► Validated measures were administered in clinic and linked to electronic medical records. ► Depression and seizure control were equally important predictors of quality of life. ► The impact of depression was independent of seizure severity. ► The use and feasibility of an online tool for clinical data collection were demonstrated.